Abstract
Patients with cardiometabolic syndrome have twice higher cardiovascular risk and 5 times higher risk for type 2 diabetes development in comparison to subjects without cardiometabolic syndrome. The lipid trias (high triglycerides, low HDL cholesterol and small dense LDL particles) characterizes typical atherogenic dyslipidaemia in the patients with insulin resistance.
High cardiovascular risk is done by small dense LDL cholesterol and remnant cholesterol, which is a part of triglycerides rich lipoproteins remnants. Atherogenic dyslipidaemia represents a residual vascular risk, which persists in patients with well treated standard risk factors, i.e. also in statin treated patients.
Except of life style modification, combined lipid modifying therapy by statin and fenofibrate is profitable in patients with atherogenic dyslipidaemia and very high cardiovascular risk. That treatment is well tolerated, safe and influences the difficult lipid metabolism disturbances in patients with atherogenic dyslipidaemia and decreases residual risk for macrovascular (atherosclerotic) and microvascular (diabetic) complications.